OB/GYN vs. Midwife

When I got pregnant with my first child, I had never heard of a midwife. By default, I saw an OB/GYN for my prenatal care and delivery, as did everyone I knew. I also never considered the fact that I could CHOOSE or CHANGE my provider, even in the middle of pregnancy! I picked one that was convenient and accepted my insurance. I went to my appointments where they did their tests and exams, and I never really questioned anything. I delivered at the hospital closest to my house, because who wants to labor in a car, right?

But what I did not know was that there are options in childbirth. You have the choice to choose a care provider that suits your needs and your pregnancy.

Some things to consider before choosing the best care provider for your pregnancy and birth:

What type of birth do you want? Medicated, un-medicated, induced, cesarean section? This may limit where you can give birth and with whom. Home births & birthing centers cannot administer certain pain relief options and are not equipped to perform inductions or cesareans.

Where do you want to give birth? If you know you want the epidural, induction, or cesarean, you will likely need to go to the hospital for birth. A midwife may be able to see you through an epidural and/or induction, but only an OB/GYN can perform a cesarean. If you wish to forego these options, you may choose a birthing center or home birth, with a midwife.

Who do you want present at birth? Hospitals usually have pretty strict policies regarding visitors who can be present in the delivery room and there are usually age restrictions. Birthing centers may also have policies and limits, but are typically more accommodating to what you may want. At a home birth, it is up to you and your midwife entirely.

What does your insurance cover? All insurance policies are different, so be sure to check what is covered by your specific policy and whether your provider accepts your insurance. Typically speaking, home births may not be covered by your insurance, so you will face the out-of-pocket costs associated with your delivery. But just because it’s 100% out-of-pocket does not always mean it’s more expensive than your co-payments & deductibles for a hospital birth! Compare & contrast your options to find what works best for your family.

Midwives follow the midwifery model of care, which views pregnancy and birth as a natural, physiological process that typically doesn’t require any intervention in a low-risk, healthy mom. They typically are more natural-minded, though every midwife will be individual in their beliefs & philosophies. There are Certified Nurse Midwives (CNMs) who are registered nurses, specializing in midwifery, and usually work in hospitals or birthing centers. There are Certified Professional Midwives (CPMs) who have completed basic clinical training and then apprenticed under an experienced midwife to gain hands-on skills and knowledge; they typically work in birthing centers or home births. There are also direct-entry midwives and non-certified midwives who have experience, but no formal clinical training or certification.

Beyond pregnancy and birth, midwives can also offer well woman’s care. Different states have different licensing requirements, so they may or may not be licensed. However, it’s important to keep in mind that midwives are unable to perform cesarean sections, if needed. If the situation arises where you need a cesarean section, they will likely need to transfer your care to an OB/GYN.

OB/GYNs follow a clinical model of care. Individual OB/GYNs will have differing opinions and experience when it comes to pregnancy and birth, so they can be more natural-minded or clinical-minded, depending on the provider. They are the only care providers that are trained, certified, and equipped to provide care for high-risk moms and babies, and are the only ones who can perform cesarean sections, if needed. Typically, they only work in hospitals.

They also provide well woman’s care and are able to handle any non-pregnancy gynecological issues. Again, they are surgeons, so if a gynecological issue arose that required surgery, they are the ones who handle that care.

It’s important to remember that every care provider is an individual. So while one OB/GYN may take a very clinical approach for childbirth, another may take a very natural approach. The same is true for midwives. One is not better than the other for a typical low-risk pregnancy.

You should find a care provider who makes you feel heard, secure, and aligns with your beliefs about childbirth.